三维适形放疗和放疗联合化疗对中晚期食管癌患者预后影响的比较

Comparison of influence of dimensional conformal radiotherapy and radiotherapy combined chemotherapy on the prognosis of patients with esophageal cancer without surgical treatment

  • 摘要: 目的:探讨三维适形放疗和放疗联合化疗中晚期食管癌患者预后影响。方法:回顾性分析2007年6 月至2010年6 月在河北医科大学第四医院就诊的中晚期食管癌患者245 例,根据患者接受的治疗方式不同将患者分为单纯放疗组和放化疗联合治疗组,其中单纯放疗组173 例接受三维适形放疗,放化疗联合治疗组72例接受三维适形放疗联合治疗,干预后1 个月评价两组患者的疗效、不良反应、生存率。结果:联合治疗组的女性、年龄< 62岁、淋巴结出现转移、照射剂量≥ 63Gy的比例均显著高于单纯放疗组,且差异具有统计学意义(P < 0.05);两组患者的肿瘤发生部位以及Karnofasky评分的差异无统计学意义(P > 0.05);联合治疗组患者的有效率显著高于单纯放疗组,且差异具有统计学意义(P < 0.05);联合治疗组患者发生食管炎、区域性复发、白细胞及血小板下降发生率显著高于单纯放疗组,且差异具有统计学意义(P < 0.05);两组患者的骨髓移植、肺炎、放射肺纤维化、恶心、呕吐、食欲下降的发生率差异无统计学意义(P > 0.05);联合治疗组患者5 年的生存率均显著高于单纯放疗组,且差异具有统计学意义(P < 0.05)。 结论:对于中晚期食管癌患者,放化疗联合治疗与单纯放疗相比可以提高治疗有效率与患者生存率,引发的不良反应均在耐受范围内,值得临床推广。

     

    Abstract: Objective:To compare the influence of three-dimensional conformal radiotherapy and radiotherapy combined chemothera -py on the prognosis of patients with advanced esophageal cancer.Methods:A retrospective analysis from June2007to June2010in our hospital was conducted on 245 patients. Depending on the treatment, patients were classified into simple radiotherapy group and chemoradiothearapy group ,both of which received three-dimensional conformal radiotherapy. A total of 173 patients were in the radi -ation and chemotherapy combined treatment group, while 72cases were in the simple radiothearapy group. One month after inter -vention, efficacy, adverse reactions, and survival rates of the two groups of patients were compared.Results:The proportion of wom -en in the combination therapy group, aged < 62years, the proportion of lymph node metastasis occurrence and dose≥ 63Gy ratio were significantly higher than those in the radiotherapy group, respectively. The difference was statistically significant (P<0. 05). Howev -er, the tumor location and Karnofasky scores of two groups of patients indicated a difference that was not statistically significant ( P>0. 05). The combined treatment group results were significantly higher than the efficiency of the radiotherapy group. The difference was statistically significant (P<0. 05). In the combined treatment group, significant differences were observed in the incidence of esoph -ageal inflammation, regional recurrence, white blood cell, and platelet decrease. The difference was statistically significant (P<0. 05). However, the difference in the incidence of bone marrow transplantation, pneumonia, radiation pulmonary fibrosis, nausea, vomiting, and loss of appetite was not statistically significant (P>0. 05). The five-year survival rate of combination group were significantly higher than that of the radiotherapy group, and the difference was statistically significant (P<0. 05). Conclusion: For advanced esophageal car -cinoma patients, radiotherapy and chemotherapy combined with radiotherapy improved efficiency of treatment and effectively im -proved survival rate. Although the proposed treatment could lead to adverse reactions, these effects are within the range of tolerance, which makes the said treatment worthy of clinical promotion.

     

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